Pathways to Discovery: Winter 2013

New research is examining how religion and spirituality guide treatment decisions in patients with cancer. By understanding this relationship, UCCCC researchers may find new ways to integrate religion and medicine to improve outcomes for patients.

Coping with Cancer
Several years ago, Blase N. Polite, MD, MPH, an assistant professor of medicine who has expertise in colon cancer and health disparities, interviewed patients to understand why some failed to receive chemotherapy treatment. He hypothesized that social support was a factor; however, questions related to religion and spirituality drew the largest response. “It jumped off the page,” he said. “That was what people wanted to talk about.”

Dr. Polite conducted a larger follow-up study and observed marked differences by race. He sought help from religiosity experts to understand differences in how people view the role of God. For many patients, particularly African Americans, religion and spirituality played a prominent role in their cancer diagnosis, but with varying implications.

For example, although faith can be an important resource for coping during illness, it can also be an impediment to seeking or adhering to treatment. The data showed that patients who strongly agreed with the statement, “God is in control of my cancer,” and “If a person prays about cancer, God will heal it without medical treatment,” were less likely to complete curative chemotherapy.

A Deeper Understanding
With funding from the Templeton Foundation, Dr. Polite and colleagues are now pooling data from 600 patients at 9 different hospitals across the Chicago area, including the University of Chicago Medicine, to analyze how spirituality is incorporated into treatment-related decisions. The study will focus on colon cancer, a disease for which a widening survival disparity exists among African Americans compared to other ethnic groups. Detailed surveys and focus groups will capture how religion influences patient healthcare decisions, as well as how healthcare teams might address the faith of their patients.

“Through a much more elaborate set of questions, this study will provide us with a much deeper understanding of how people’s relationship with God relates to cancer,” said Dr. Polite. For the subset of patients who hold a fatalistic view of cancer (“It’s God’s will” and “God will decide what happens to me”), the researchers are interested in finding ways to help this group use their religious faith as a source of strength and comfort, rather than avoid care.

Chaplaincy-Based Interventions
Since religion has been traditionally left out of patient-physician dialogue, Dr. Polite and colleagues have teamed with George Fitchett, DMin, PhD, associate professor of preventative medicine at Rush University and a national leader in training chaplains, to design a pilot chaplain-led intervention program that acknowledges the importance of spirituality when a patient is diagnosed. “If we can work together with our chaplains and patients to continue using religion as a source of strength during their treatments, then we may be able to address an important factor in cancer disparities,” said Dr. Polite.

He added that future research will assess whether the chaplaincy intervention improves patient satisfaction and compliance with therapy. “We hope to bring scientific and religious communities together by opening dialogue and creating discourse that will ultimately lead to improved outcomes for patients,” he said. Aasim Padela, MD, MSDc, assistant professor of medicine, is also studying the impact of religious beliefs on healthcare behaviors among American Muslims.